Perm Medical Journal

”Perm Medical Journal” (ISSN Key title: Permskiĭ medit︠s︡inskiĭ zhurnal) is a referred scientific and practical journal. It was founded in 1923 by Medical Society of Perm University. Since 2001 the founders of “Perm Medical Journal” are Perm State Academy of Medicine and Perm Research Center of Russian Academy of Medicl Sciences and Administration of Perm Region. Since 2017, the founder is Academician E.A. Vagner Perm State Medical University.

Editor-in-Chief: Evgeny G. Furman, MD, PhD, Corresponding Member of the Russian Academy of Sciences (Wagner State Medical University, Ministry of Health of the Russian Federation, Vice-Rector for Research)

The journal is registered by the Roskomnadzor agency (licensee ЭЛ № ФС 77-75489 on 05.04.2019).

“Perm Medical Journal” is included into the list of the leading scientific journals and editions of the Russian Federation intended for publication of basic scientific results of theses for a degree of Doctor of Science.

01.14.01 - Obstetrics and gynecology (medical sciences)
01.14.02 - Endocrinology (medical sciences)
3.1.21 - Pediatrics (medical sciences)
01.14.12 - Oncology (medical sciences)
3.1.9 - Surgery (medical sciences)
01.14.25 - Pulmonology (medical sciences)
3.2.2 - Epidemiology (medical sciences)
03.14.09 - Clinical immunology, allergology (medical sciences)
03.14.10 - Clinical laboratory diagnostics (medical sciences)

PubMed News Global

 

A 2-Phase Survey to Assess a Facility's Readiness for Pediatric Essential Emergency and Critical Care in Resource-Limited Settings: A Literature Review and Survey Development

18.08.2022

CONCLUSIONS: A comprehensive 2-phase survey was created to evaluate facility readiness for pediatric critical care. Results will assist hospital administrators and policymakers to determine priority areas for quality improvement, enabling them to implement a Plan-Do-Study-Act cycle to improve care for the critically ill child.

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COVID-19 Vaccine Uptake Among US Child Care Providers

18.08.2022

CONCLUSIONS: COVID-19 vaccine uptake among US child care providers was higher than the general US adult population. Those who were younger, lower income, Black or African American, resided in states either in the Mountain West or the South, and/or worked in home-based child care programs reported the lowest rates of vaccination. State public health leaders and lawmakers should prioritize these subgroups to realize the largest gains in vaccine uptake among providers.

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Biologics for Asthma and Allergic Skin Diseases in Children

18.08.2022

An estimated 7 million children in the United States have asthma, which causes a significant health care burden and affects quality of life. The minority of these children have asthma that does not respond to Global Initiative for Asthma steps 4 and 5 care, and biological medications are recommended at this level in the 2019 Global Initiative for Asthma recommendations. In addition, biologics have been introduced into the care of children with allergic skin diseases. Omalizumab and mepolizumab...

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Current Issue

Vol 39, No 3 (2022)

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Original studies

Changes in lipid metabolism among patients with seborrheic dermatitis
Elkin V.D., Kobernik M.Y., Sedova T.G., Borodina E.N., Kuznetsov I.D.
Abstract

Objective. To conduct a comparative analysis of metabolic and hormonal changes in patients with seborrheic dermatitis depending on age. Seborrheic dermatitis is a common chronic inflammatory skin disease that occurs as a result of impaired sebum production and the addition of the yeast fungus Malassezia furfur. Disorders of the endocrine, immune and nervous systems of the body can contribute to the development of dermatosis; sexual and age characteristics are also important. Malassezia furfur influences changes in the biochemical composition of sebum and supports the inflammatory response, exacerbating pathogenetic changes.

Materials and methods. The study involved 62 patients with seborrheic dermatitis, who formed two groups: group I consisted of 32 patients aged 20–30 years; group II – 30 patients aged 40–50 years. The groups were comparable by gender (men) and social status; all were residents of the Perm Region. The exclusion criteria were the presence of proved cardiovascular and endocrine pathology, malignant neoplasms, liver and kidney failure, HIV infection, autoimmune diseases. The study consisted of an assessment of the general condition and dermatological status as well as laboratory methods, including general blood and urine tests and biochemical blood analysis with indicators of the lipid spectrum, carbohydrate metabolism, liver enzymes and male sex hormones.

Results. In patients with seborrheic dermatitis aged 20–30 years, the level of blood lipids was within physiological values. In patients with seborrheic dermatitis older than 40 years, the lipid metabolism disorders were noted, especially an increase in cholesterol, LDL and atherogenicity index. No significant changes in carbohydrate metabolism, liver enzymes, hyperandrogenemia were observed in both groups, no significant difference between the studied groups according to these criteria was revealed.

Conclusions. At young age, seborrheic dermatitis in men develops without significant metabolic disorders. Seborrheic dermatitis in men over 40, is mainly accompanied by hyperlipidemia; such patients need additional examinations and observation by a cardiologist.

Perm Medical Journal. 2022;39(3):5-10
pages 5-10 views
Clinical and electrophysiological characteristics of psychovegetative syndrome during rehabilitation after coronary bypass graft
Mirzoev R.A., Malchikova S.V., Isaeva O.V., Matantsev A.G., Chudinovskikh T.I., Kolupaev A.N., Sherman M.A.
Abstract

Objective. To investigate the impact of anxiety in development of psychovegetative syndrome in patients after operative myocardial revascularization, to describe the nature and direction of resulting autonomic dysfunction and to study the effect of treatment with anti-anxiety therapy for this condition.

Materials and methods. 54 patients aged 45–75 (36 – the main group, 18 – the comparison group), on average 11–12 days after the coronary artery bypass graft (CABG) and during the process of early and late postoperative rehabilitation were investigated. A score assessment of the psychological and autonomic spheres, and sleep quality was analyzed. Indicators of vegetative tone and vegetative regulation were assessed, in particular, temporal and spectral indicators of heart rate variability. In addition to basic therapy for ischemic heart disease (IHD), the patients of the main group received therapy with vegetative corrector.

Results. In most cases, in the early postoperative period after CABG, moderate anxiety disorders and sleep disturbance were registered in combination with autonomic dysregulation with sympathetic influences prevailing. Addition of psychotropic therapy to the basic therapy of IHD patients in the main group allowed for 10–14 days to significantly reduce the level of anxiety, improve sleep quality and correct the existing autonomic disorders with a tendency to further regression in the late postoperative period.

Conclusions. This study found that patients with an increased level of anxiety after CABG are characterized by the formation of a psychovegetative syndrome with predominance of sympathetic activity. The use of anxiolytic therapy can reduce the severity of anxiety and autonomic dysfunction, which can probably become an additional factor contributing to successful rehabilitation of patients after CABG in the early and late postoperative periods and prevention of IHD progression.

Perm Medical Journal. 2022;39(3):11-24
pages 11-24 views
Dynamics of metabolic parameters of liposuction: physical rating, basal metabolic rate and metabolic age
Khramtsova N.I., Plaksin S.A., S. A.Y., Ponomarev D.N.
Abstract

The purpose: To analyze the possibilities of usage and the dynamics of such metabolic parameters as physical rating, basal metabolism and metabolic age, in evaluating the results of liposuction.

Materials and methods. The following body composition indicators were measured: physical rating, basal metabolism, and metabolic age. The study included 26 relatively healthy women before liposuction, immediately after the surgery and on the 7th day after it, which were measured with Tanita BC-542 two-electrode body composition analyzer. The significance of differences was assessed using the Wilcoxon test with an error value of p <0.05.

Results. The physique rating immediately after liposuction in 3 (11%) patients improved, remaining on the 7th day, in one (4%) woman it has deteriorated. In 22 (85%) women it has not changed. The basal metabolic rate in patients on admission was 1333 (1265-1407) kcal. After liposuction it increased to 1340 (1289-1394) kcal (p = 0.02), on the 7th day - 1357 (1319-1482) kcal (p = 0.04). Metabolic age on admission in 14 (54%) patients was less than actual, in 1 (4%) woman in matched, in the remaining 11 (42%) it was more than the actual. Immediately after liposuction, the metabolic age corresponded to the actual in 6 (23%) patients, in 13 (50%) it was less than the actual age, in the remaining 7 (27%) it increased. On the 7th day the metabolic age in 16 (89%) decreased, while in the remaining 2 (11%) it did not change. On the 7th day it neither increased.

Conclusions. In most patients, metabolic rates improved after liposuction, but in one case, the "deterioration" of physique rate was recorded. The procedure for measuring metabolic parameters in estimating the results of liposuction requires improvement.

Perm Medical Journal. 2022;39(3):25-33
pages 25-33 views
Electrocardiographic and cardiobiochemical reactions in patients with closed chest injury
Vakhrushev D.S.
Abstract

Objective. To study the electrophysiological and clinicobiochemical characteristics of cardiovascular system in closed injury of the chest.

Materials and methods. There were examined 114 persons diagnosed the closed chest injury, who were admitted to the Thoracic Unit of City Clinical Hospital №9 in Izhevsk. The causes and mechanisms of injuries, the data of clinical and functional methods of investigations of cardiovascular system, the data of case histories and previous preventive examinations were analyzed. The comparison group involved 50 practically healthy men.

Results. The mean age of the persons in the main group and the comparison group was 45.9 ± 12.8 years and 44.7 ± 11.5 years, respectively. The prevailing causes of injury were the following: road accident – 17 persons (14.9 %), fall from a height (higher than one’s own height) – 32 persons (28.0 %), fall from a height of one’s own height – 37 persons (32.5 %). The increased values of the markers of myocardium damages and inflammatory reaction as well as the changes in electrocardiographic parameters were established among the examined persons.

Conclusions. The closed chest injury occurs mainly in the able-bodied population that, of course, is an actual factor for a possible unfavorable labour prognosis. When analyzing the ECG parameters and cardiometabolic characteristics, there were detected the deviations earlier absent in these patients and in patients of the comparison group, which showed the myocardial damage.

Perm Medical Journal. 2022;39(3):34-40
pages 34-40 views

Review of literature

New-onset type ii diabetes mellitus in early diagnosis of pancreatic cancer: literature review
Ponomarev P.A., Moiseenko V.E., Pavlovsky A.V., Popov S.A., Turlak A.S., Granov D.A.
Abstract

The literature data on the connection between type 2 diabetes mellitus (DM) and pancreatic cancer (PC) were analyzed. Early detection of pancreatic cancer remains an unsolved problem of oncology because of absence of pathognomonic symptoms for this disease at the early stages, difficulties in visualizing changes in the pancreas as well as difficulties in differential diagnosis with benign tumors. Fifty nine articles in Russian and English were studied, and the data presented in literature regarding the connection between type 2 diabetes mellitus and early stages of pancreaticic cancer have been analyzed.Resectable pancreatic cancer makes up less than 15 % of the cases during initial medical examination. Currently, the existing methods of diagnostics do not allow solving the problem of early detection of pancreatic cancer – it dictates the need to search for a new marker that will improve the early diagnosis of this tumor. According to the results of many studies, there has been detected a connection between the new-onset type 2 diabetes mellitus and early stages of pancreatic cancer. Based on the data published by a number of authors, manifestation of the new-onset type 2 diabetes mellitus in patients over fifty (fasting blood glucose level ≥ 7 mmol/L, or a blood glucose sugar level ≥ 11,1 mmol/L after performing oral glucose tolerance test, or random blood glucose level ≥ 11,1 mmol/L with a typical hyperglycemia signs and symptoms) can serve as an early symptom of pancreatic cancer.

Thus, the new-onset type 2 diabetes mellitus in persons aged 50 years or older can potentially be used to identify a group of patients requiring a directional examination for the purpose of early detection of pancreatic cancer. Further studies on this problem could allow us to formulate a special program of early diagnostics of pancreatic cancer.

Perm Medical Journal. 2022;39(3):41-54
pages 41-54 views
Penetrating wounds of vertebral arteries: literature review
Karasov I.A., Antonyan A.A., Samartsev V.A., Oparin A.Y., Kruglov E.V.
Abstract

Penetrating wounds of the vertebral artery is an extremely rare pathology; its weight is not large even among the damages of the cervical vessels. This life-threatening state due to its rarity is not always diagnosed in time, and in case of a timely diagnostics, it is a complicated task for a surgeon. The paper presents the data regarding prevalence of penetrating damages of the vertebral arteries, anatomy and development of these vessels, methods of diagnostics and treatment of these wounds as well as complications and outcomes.

Perm Medical Journal. 2022;39(3):55-62
pages 55-62 views

Methods of diagnosis and technologies

Diagnostics and correction of microcirculation disorders and endothelial dysfunction in complex therapy of acute pancreatitis with antioxidant drugs
Samartsev V.A., Gavrilov V.A., Podtaev S.Y., Pushkarev B.S., Domrachev A.A., Sidorenko A.Y.
Abstract

Objective. To assess the efficiency of using polypositional skin thermometry of high resolution with wavelet-analysis of the obtained curve as a screening noninvasive method for diagnostics and correction of microcirculatory disorders and endothelial dysfunction in complex therapy of acute pancreatitis using antioxidant drugs.

Materials and methods. A prospective open randomized study of 30 patients with acute pancreatitis was carried out. The polypositional skin thermometry of high resolution with wavelet-analysis of the obtained curve was chosen as a screening method of diagnostics of microcirculatory disorders and endothelial dysfunction. Measurement of temperature oscillation amplitude with an accuracy to 0,001 °С was performed in conditions of skin heating with index finger. The study was implemented before and after calf blood deproteinized hemoderivative infusion.

Results. Reliable changes in skin temperature oscillation of the microcirculatory bed of the skin in the endothelial range on the days 1, 2 and 3 of drug infusion were detected. In the investigated group of patients, the phenomena of transitory organ dysfunction were arrested during 48 hours that proves the presence of pancreatitis of a moderate degree of severity. The temperature oscillation amplitudes of skin in neurogenic range significantly differed by the moment of arresting organ dysfunction.

Conclusions. The method of polypositional skin thermometry of high resolution with wavelet-analysis of the obtained curve can be offered as an instrument for assessment of endothelial dysfunction prior to appearance of clinical manifestations of acute pancreatitis. The calf blood deproteinized hemoderivative infusions applied as a metabolic therapy positively influence the endothelial dysfunction in acute pancreatitis of a moderate degree of severity.

Perm Medical Journal. 2022;39(3):63-72
pages 63-72 views
Features of human monocytic ehrlichiosis laboratory diagnostics
Teterin V.Y., Korenberg E.I., Nefedova V.V., Vorobyova N.N., Sumlivaya O.N., Okishev M.A., Semerikov V.V.
Abstract

Objective. Using the data obtained in Perm Region as an example, to identify the effectiveness of polymerase chain reaction (PCR) for the diagnosis of Human Monocytic Ehrlichiosis (HME) at different periods from the onset of the disease, and to determine the role of HME in the structure of infections transmitted by ixodic ticks using PCR and enzyme-linked immunosorbent assay (ELISA)

Materials and methods. A thorough clinical and epidemiological examination of 583 patients with acute febrile diseases developed after the suction of ticks was carried out. To detect E. muris DNA, 1586 whole blood samples were examined by PCR at different periods from the onset of the disease. For the purpose of serological verification of HME, all patients were examined with ELISA for the presence of immunoglobulins M and G against E. chaffeensis.

Results. In total, using the PCR method, ehrlichial DNA was detected in 76 (4.8 %) blood samples from 53 patients. Based on two research methods (ELISA and PCR) HME was diagnosed in 58 (9.9 %) persons, while in 50 (86.2 %) of them, the diagnosis was confirmed only by PCR. The timing of E. muris genomic material detection in the blood of patients varied from 1 to 58 days from the moment of the disease. The greatest effectiveness of PCR (up to 69.4 % of positive samples) was noted by us from the 1st to the 7th day of illness. HME was found in the form of monoinfection – in 9 (15.5 %), mixed infection – in 49 (84.5 %) persons. The following was revealed: HME+Ixodid tick-borne borreliosis (ITBB) in 35 (60.3 %), HME+ITBB+Human granulocytic anaplasmosis (HGA) – in 6 (10.3 %), HME+ITBB+HGA+Tick-borne encephalitis (TBE) – in 4 (6.9 %), HME+TBE – in 2 (3.5 %), HME+TBE+ITBB – in 2 (3.5 %).

Conclusions. In the diagnosis of HME, PCR significantly increased the number (up to 86.2 %) of confirmed cases, and most often in the acute period of the disease (up to 69.4 ± 15.3 % of positive samples in the first week of the disease). For laboratory verification of HME, it is advisable to combine ELISA with the PCR method, especially in case of negative results of serological studies.

Perm Medical Journal. 2022;39(3):73-82
pages 73-82 views
Standard determination of clinical case of measles in conditions of its elimination
Semerikov V.V., Vorobyova N.N., Postanogova N.O., Okishev M.A., Uvarova E.Y., Nebolsina A.P., Metelkina N.A., Sofronova L.V., Nikolaev A.V.
Abstract

Objective. To develop a standard determination of a clinical case of measles in conditions of its elimination.

Materials and methods. The study included 28 patients with measles (main group) and 30 with infectious mononucleosis (comparison group). By means of correlation analysis, among clinicolaboratory indicators there was determined a list of clinical signs, which statistically significantly were more often identified in patients with measles compared to patients with infectious mononucleosis. The mathematical model was developed using the method of logistic regression, which helped to single out the most qualitative binary classifiers directly connected with diagnostic probability of measles. Sensitivity and specificity of the obtained model were calculated. For statistical processing IBM SPSS Statistics 26 was used.

Results. To carry out a standard determination of a clinical case of measles with the presence of combined clinicolaboratory symptoms, the mathematical model was developed, described by the following equation: р=1/(1+е-z) · 100, where z=71,7+36,8 · Х dry cough +53,5 · Х maculo-papular rash +17,6 · Х damages of eyes in the form of conjunctivitis and/or sclerite. Taking into account the regression coefficient values, such clinicolaboratory symptoms as maculo-papular rash, damages of eyes in the form of conjunctivitis and/or sclerite were directly connected with diagnostic probability of the diagnosis “Measles”. The determination coefficient of the obtained model was R2 = 0,97, p < 0,001. The sensitivity of the model was 96.4 %, specificity – 100 %, efficiency – 98 %.

Conclusions. In conditions of measles elimination, the combination of maculo-papular rash, damages of eyes in the form of conjunctivitis and/or sclerite allows confirming the clinical diagnosis of measles with the probability of 98 %.

Perm Medical Journal. 2022;39(3):83-89
pages 83-89 views

Preventive and social medicine

Current medical and social aspects of tobacco and nicotine-containing products consumption in adolescents
Melnikova I.M., Dorovskaya N.L., Dmitrieva A.P., Mizernitskiy Y.L.
Abstract

Objective. To determine the trends in the structure and assess medical, social and clinical aspects of the consumption of tobacco and nicotine-containing products among adolescents aged 14–17.

Material and methods. During the study, 352 adolescents aged 14 to 18 years studying in urban (n = 202) and rural (n = 150) schools of Yaroslavl region were surveyed in 2020–2021. Statistical processing of the data was carried out using computer programs "Statistica" v.10.0.

Results. The survey of teenagers revealed a fairly high prevalence not only of active tobacco smoking (tried 37 %, actively smoked 30 % of adolescents), but also the use of "new" nicotine-containing products (vape, hookah, electronic cigarettes, snus, snuff) (tried 38 %, actively used 7 % of teenagers). The structure of active tobacco use and NRTI use was found to differ by the place of residence. Active tobacco use accounted for 46.7 % of rural adolescents and 19.8 % of urban residents (p < 0,01).

Conclusions. In modern adolescents, along with tobacco smoking, a negative trend has been detected to increase the use of nicotine-containing products, especially hookah. This substantiates the need to improve educational anti-nicotine programs, to introduce a system of regular regional monitoring of the prevalence of traditional and new nicotine-containing products use among children and adolescents in order to make quick and effective decisions.

Perm Medical Journal. 2022;39(3):90-101
pages 90-101 views
Effectiveness of antiepidemic events in tuberculosis in context of changing epidemic process trend
Dorofeeva I.K., Logvin F.V., Maksimova E.A., Chernigovets L.F., Tyutyunkova N.G., Batashev V.V., Chernaya A.S.
Abstract

Objective. To study the features of the formation of the epidemic situation for tuberculosis and to evaluate the effectiveness of antiepidemic events in separate age groups.

Materials and methods. A retrospective analysis of the incidence of tuberculosis in Rostov-on-Don from 1992 to 2017 was conducted. The dynamics of the incidence of active tuberculosis, respiratory system tuberculosis and forms with bacillus discharge with the determination of the trend and its quantitative assessment was studied; the age structure of tuberculosis patients was analyzed depending on the direction and severity of the trend.

Results. The incidence of tuberculosis has been increasing in Rostov-on-Don since 1993, and from 2003 to 2008, the average long-term incidence of active tuberculosis, respiratory tuberculosis and forms with bacillus excretion was maximum. Since 2009, the direction of trends has changed, the period from 2009 to 2013 is characterized by a "pronounced" downward trend and since 2014, the incidence rates have been minimal. In the age structure of patients with active tuberculosis, the proportion of persons aged 40-49 is decreasing, and in 2014–2017, the proportion of persons aged 50–59 years is also falling. Since 2009, the proportion of persons aged 18–29 has increased, and in 2009–2013 the proportion of children has grown. In 2014–2017, the proportion of persons over 60 years of age increased among those who fell ill.

Conclusion. The most effective events are carried out in the group of 40–59 years, less effective – among children and persons aged 15–17 and 30–39 years. The results of the research will allow us to adjust preventive measures among children, teenagers and young people.

Perm Medical Journal. 2022;39(3):102-113
pages 102-113 views
Epidemiological assessment of long-term maternal and failed maternal mortality
Padrul M.M., Isaeva N.V., Cherkasova E.V., Berseneva S.N.
Abstract

Objective. To conduct epidemiological studies of the long-term dynamics of maternal mortality (MM) and failed maternal mortality, development of trends and territorial distribution.

Materials and methods. The data of official statistics on maternal mortality calculated for

100 000 live births and a long-term dynamics of unrealized maternal mortality according to the data of the Ministry of Healthcare of PK "Unified Information System of Healthcare of Perm Krai" are presented. The number of cases of complicated pregnancy, childbirth and the postpartum period with the formation of multiple organ dysfunction or insufficiency requiring intensive therapy, blood transfusion and emergency surgical interventions was calculated. The epidemiological descriptive and evaluative method was used when performing the studies. The long-term dynamics of MM was calculated, the rectilinear epidemic trend for the function of the parabola y1 = a + bx and the curvilinear tendency for the function of the parabola y2 = a + bx + c2, its upper and lower confidence bounds (Me ± 0.95) were determined. The rate of growth and increment were investigated and the research cyclical fluctuations were determined.

Results. The maximum level of maternal losses (ML) in Perm Krai established in 2003 was 44.2 per 100 thousand live births. The minimum figure in 2015 was 5.2 per 100 thousand live births. The average long-term indicator of MM is 19.3. A feature of the long-term dynamics of the studied period was a steady decline in MM with an average annual rate of 5.7 %. Cyclical fluctuations were initially regular in nature, and subsequently had a lengthened rhythm of 13 years. Failed maternal mortality in Perm Krai had a pronounced downward trend; the decrease rate was 518.9 %. The annual loss rate was 69.8 %.

Conclusions. The long-term dynamics of MM in Perm Krai was characterized by an average degree of intensity, an epidemic tendency to decrease, the presence of cyclical fluctuations, the formation of internal causes testifying to the possible activation of maternal losses. The long-term dynamics of failed maternal mortality had a pronounced downward trend.

Perm Medical Journal. 2022;39(3):114-121
pages 114-121 views

Clinical case

Connective tissue dysplasia in surgery
styazhkina S.N., Capustin B.B., Malchicov A.Y., Chernyshova T.E., Kononova N.Y., Usachev A.V., Shisterova E.V.
Abstract

Objective. To identify the features of connective tissue dysplasia in patients undergoing treatment in the Surgical Unit of the First Republican Clinical Hospital of Izhevsk.

Materials and methods. The study of connective tissue pathology was conducted in patients with surgical diseases on the basis of the Surgical Unit of the "First Republican Clinical Hospital of the Ministry of Healthcare of the Udmurt Republic".

Results. The following phenotypic manifestations of connective tissue dysplasia were revealed in the examined patients: asthenic type of constitution; body weight deficiency; dolichostenomelia; arachnodactyly; deformities of the chest and spine; joint mobility; atrophic striae, skin hyperextension; longitudinal and transverse flat feet; ventral and inguinal hernias; varicose veins.

Conclusions. Thus, the variety of clinical symptoms in connective tissue pathology indicates the systemic nature of the lesion since connective tissue is located in almost all organs and systems and has a number of important functions. In its turn, underestimating the importance of connective tissue dysplasia leads to the development of severe complications, which require early diagnosis, timely prevention, and, if necessary, adequate complex therapy and rehabilitation of patients with this syndrome.

Perm Medical Journal. 2022;39(3):122-130
pages 122-130 views
Retroperitoneal abscess as a rare disease: clinical case
Shlyapina K.S., Ahunova R.A., Styazkina S.N., Abramovich A.A.
Abstract

Objective. To monitor the dynamics of the patient’ status, to investigate the quality and nature of the received therapeutic care for patients with retroperitoneal abscess.

Materials and methods. The literature on retroperitoneal abscess as well as a medical record of an ambulatory patient diagnosed retroperitoneal abscess was studied and analyzed.

Results. The study of this pathology helped us to better understand the pathogenesis of this disease and choose a treatment method. Treatment helped all patients; no complications were observed.

Conclusions. The quality and nature of treatment received by doctors meet the necessary requirements helping a patient to improve the quality of life.

Perm Medical Journal. 2022;39(3):131-136
pages 131-136 views

Biology and experimental medicine

Modeling of bleeding from varicose vein of esophagus in a laboratory animal
Budarev V.N., Chekushin A.A.
Abstract

Objective. To develop an accessible, easily reproducible, functional method for modeling bleeding from varicose veins of the esophagus based on the body of a laboratory animal.

Materials and methods. The work is based on an experiment carried out in the operating room of the vivarium of Ryazan State Medical University using laboratory animals – 12 domestic pigs of the Large White breed.

Results. In 10 cases out of 12, it was possible to successfully form changes in the animal's body, allowing to provoke bleeding from the dilated veins of the esophagus, damaging them with biopsy forceps during fibroesophagoscopy.

Conclusions. Creation of an experimental model of bleeding from varicose veins of the esophagus in the body of a domestic pig by dosed clamping of the hepato-duodenal ligament with a plastic clamp, which was followed by subsequent damage of the esophageal veins with biopsy forceps during fibroesophagoscopy, is technically feasible, reliable, and the model itself is quite functional.

Perm Medical Journal. 2022;39(3):137-142
pages 137-142 views
Preclinical acoustic efficiency evaluation of bionic ear
Arutyunov S.D., Yuzhakov A.A., Bezukladnikov I.I., Astashina N.B., Elovikov A.M., Baydarov A.A., Mayorov P.V.
Abstract

Objective. To study the major acoustic properties of the prototype of bionic ear developed in order to confirm its functional performance.

Materials and methods. Acoustic properties of the bionic ear were measured using Random Phase MultiSine signal in a test bench, which simulated the implant-emitter-osseous tissue-inner ear system. The resulting pulse response was converted to the target characteristics: FR and group lag. Experiments were carried out for -6dB signal level, 10 times for each of the methods used.

Results. Microtia is a congenital auricular hypoplasia or aplasia (anotia) which often involves impairment or total loss of hearing. One way to rehabilitate this type of patients is to use bone-conducting apparatuses (bone anchored hearing aids), which allow to compensate for the functional component but not to restore facial aesthetics. This paper deals with major acoustic properties of the prototype bionic ear we have previously developed, in order to confirm its functional performance for clinical use. Our analysis of acoustic characteristics of the bionic ear system showed the frequency response was uniform enough in extended voice frequency range (100 to 10000 Hz). The experimental research demonstrated that operating time of the prototype bionic ear to battery depletion is 10 h 26 min with 25 % amplification, 10 h 05 min with 50 % amplification, 9 h 48 min with 75 % amplification.

Thus, the acoustic characteristics of the vibratory emitter were determined, which confirmed that the bionic artificial ear was eligible for clinical testing.

Conclusions. Major frequency response of the vibratory emitter was measured, and confirmed that preclinical studies were successful and the bionic ear was eligible for clinical testing.

Perm Medical Journal. 2022;39(3):143-153
pages 143-153 views

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